Back To The Basics: Your Pelvic Floor

If you have ever worked with me, you know how passionate I am about helping you to

understand your body. I get overly excited to teach about the pelvic floor and my fun facts to

help you understand why you are in pain, or having the symptoms that you are. It is at large

overlooked and unknown, making pain and symptoms related to this muscle group very scary. I thought I would share some of my "Theresa-isms" and fun facts. If you have already heard them - I hope this serves as a good reminder, if you haven't – ENJOY!!

Your pelvic floor is a group of muscles that make up the bottom of your pelvis. In this picture (above), you can see your hip bones on either side, and then the base of your spine at the top. The pelvic floor muscles span between these bones to create a group of muscles called the pelvic floor. This picture shows the deepest layer of the pelvic floor. The superficial layer lies on the other side, and helps with sphincter controls for the anal and urethral openings.

What do these muscles do?

The deepest layer of the pelvic floor works to create stability throughout the pelvic girdle, and to also help with support to the organs inside. It also works with our breathing (SO important that it gets its own box!!). When these muscles are too strong or too weak (or most often a combination) there can be pain or problems with bowel, bladder and/or sexual function.

Pelvic Floor and Breathing

As you breathing in, the air fills your lungs and your belly should naturally expands as the pelvic floor moves down. Then when you exhale, the pelvic floor and abdominals work together to move up and in to help push air out. This creates a sump pump effect that is extremely important for lymphatic drainage, gut motility and abdominal bloating. This coordination also plays a big role in leaking with sneezing, coughing or laughing.

What do Kegels have to do with it? 

A Kegel is the common name for a pelvic floor contraction. Some people will cue it as using the muscles to stop the flow of urine. Some people will even try to do a "Stop Test" and actually try to stop the flow of urine while toileting. This is not healthy for your bladder or pelvic floor.

To perform a pelvic floor contraction (a.k.a Kegel) you want to activate the muscles of both the superficial and deep layers. For female anatomy it is a close and lift, for male anatomy it is pulling the penis in and then lifting. This should be done on the exhale.

Not all pelvic floors need strengthening - if the muscles of the pelvic floor are too tight, or not balanced - doing pelvic floor contractions can feed into these restrictions.

What if my Pelvic Floor is too tight? How will I know?

Most often pain (abdominal, perineal or pelvic) is a sign of pelvic floor tightness. People will

often complain of heaviness or pressure. Sometimes urinary frequency, sexual dysfunction and constipation can also be signs that there is tightness in the pelvic floor muscles. Without

assessing the pelvic floor muscles directly, it can be difficult to diagnose them as tight or weak.

The pelvic floor muscles are similar to layers of an onion with our hip girdle on the outside and the pelvic floor deep inside. Stretches that open up the hips can help to take pressure off tight pelvic floor muscles.

The Balance of Strength and Flexibility

Like any other muscle group, the pelvic floor muscles need a balance. Using my bicep as an

example, if it were too tight and my elbow was stunk bent, I couldn't pick anything up. If it were too weak, and I couldn't bend my elbow, I still couldn't pick anything up. The pelvic floor muscles are similar, still muscles that need balance - just in a different place.

Bladder Health and Your Pelvic Floor

• The bladder should be able to hold 2 cups of urine

• "Normal" urination is every 2-3 hours, about 6-8 times a day

• You should not get up to use the bathroom at night UNLESS you are over 65, then you

can get up ONCE

• It is not normal or OK to leak urine at any age

• Your bladder and pelvic floor have inverse activations that occur from a feedback loop

at your spinal cord. Your bladder contracts to empty, telling your pelvic floor to relax

and allow for urine to come out. The opposite happens when you contract your pelvic

floor, the bladder relaxes to allow for filling. This is important to help with urge

incontinence (leaking before you get to the toilet), completely emptying your bladder or leaking urine after using the bathroom (post-void dribble).

How do I keep my Pelvic Floor Healthy?

(I promise I tried to keep this list short - there are more ways if you want them :))

• Drink plenty of water to support bowel and bladder function

• Daily movement and walking

• Taking time to belly breath

• Manage stress - stress and pelvic floor tightness are closely linked

• Avoid constipation

• Manage hip mobility and muscle length with stretching

  
  

More questions about your pelvic floor and any of these functions? I love helping people

to understand their bodies and how these muscles are related to their symptoms. I

always tell people that when we find something wrong with a muscle that's a good thing

- we can change muscles!